Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 7246 | MT |
NPI | 1033293444 |
---|---|
Provider Name | Brock P. Whittenberger |
First Address | Billings, MT 59107-5100 |
Second Address | Billings, MT 59101-0905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 16/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000004741 | BCBS PIN (01) | MT |
0111010 | MDCD PIN (01) | MT |
101787000 | MDCD PIN (01) | WY |
17263 | ND BCBS (01) | ND |
A13136 | (02) | MT |